Biomedical subjects

Elizabeth J D'Amico

Publications and source records attributed to Elizabeth J D'Amico.

15 recordsLinked to original sources

PubMed2007

Problem drinking among Cambodian refugees in the United States: how big of a problem is it?

OBJECTIVE: The present study assesses current drinking behavior in a representative sample of Cambodian refugees. Earlier estimates of alcohol use in this population suggest that Cambodian refugees are at elevated risk for alcohol-use problems, but these studies have relied on convenience samples and may not reflect current consumption patterns. METHOD: A cross-sectional, face-to-face interview was conducted in Khmer on a household probability sample of Cambodian refugees residing in the largest such community in the United States. The overall response rate was 87% and yielded 490 respondents in the current analyses. RESULTS: Rates of consumption and alcohol-use problems were low in this population. Few participants (26%) reported any alcohol consumption in the 30 days preceding the interview, and only 2% reported any heavy drinking in the last 30 days. Multivariate analyses indicated that younger participants and men were more likely to report any recent drinking, and men were more likely to report any heavy drinking. Notably, recent consumption was not related to degree of trauma exposure or extent of psychiatric distress when controlling for age and gender. CONCLUSIONS: These data contrast dramatically with the widespread belief that Cambodian refugees are at elevated risk for problem drinking. Findings highlight the pitfalls of drawing population-based conclusions from data based on nonrepresentative samples or from nonstandard measures of alcohol consumption.

Adult↗

PubMed2006

Escalation and initiation of younger adolescents' substance use: the impact of perceived peer use.

PURPOSE: The middle school years are peak years for substance use initiation. The current study assessed the impact of peer influence on both initiation and escalation of cigarette, alcohol, and marijuana use among sixth, seventh, and eighth graders. METHODS: Youth (n = 974; 45% male) were surveyed twice over an academic year and reported on their personal substance use and their perception of peer substance use. The sample ranged in age from 10 to 15 years at Time 1 (M age = 11.95) and was 44% White, 26% Latino, 7% Asian American/Pacific Islander, 4% African American, and 14% mixed ethnic origin. RESULTS: Hierarchical regressions examined whether personal and perceived peer substance use predicted later substance involvement, and logistic regressions assessed whether Time 1 perceived peer and personal use of other substances discriminated between initiates and noninitiates. After controlling for personal substance use, perceived peer alcohol use predicted both increased alcohol and marijuana use, and perceived peer marijuana use predicted increased alcohol use. Only perceived peer alcohol use was associated with initiation of alcohol, and both perceived peer alcohol and marijuana use predicted onset of marijuana use. CONCLUSIONS: Results highlight the importance of perceived peer use in predicting both onset and escalation of use and suggest utilizing a multifaceted prevention approach that targets multiple substances.

Adolescent↗

PubMed2006

Victimization and health among indigent young women in the transition to adulthood: a portrait of need.

PURPOSE: To understand victimization by physical and sexual violence and its association with physical and behavioral health in a probability sample of sheltered homeless and low-income-housed young women in the transition to adulthood (ages 18 through 25). METHODS: Participants were 224 women ages 18 through 25 who were selected by means of a stratified random sample from 51 temporary shelter facilities (N = 94) and 66 Section 8 private project-based Housing and Urban Development (HUD)-subsidized apartment buildings (N = 130) in Los Angeles County, California. Women completed structured interviews. RESULTS: Forty-one percent of the sample had been physically or sexually victimized as children and 51% had been victimized since turning 18. Young women who experienced victimization were significantly (p < .05) more likely than non-victimized women to have a sexually-transmitted disease (STD) other than HIV/AIDS or Hepatitis B or C, vaginal discharge or bleeding and pelvic pain in the past 6 months, and past-12 month screening diagnoses of drug abuse/dependence and depression. Victimized women were also significantly more likely to use alcohol to intoxication and drugs, including crack and amphetamines, during the past 6 months, and to have experienced psychological distress and poor self-esteem. CONCLUSIONS: This study highlights striking rates of victimization and its association with physical and behavioral health problems among indigent young women during the period of emerging adulthood. This portrait of need communicates an urgency to develop multifaceted programs for such women to help them successfully navigate the transition to adulthood and realize their full potential as adults.

Adolescent↗

PubMed2006

Adolescent self-selection of service formats: implications for secondary interventions targeting alcohol use.

A novel motivational enhancement based secondary alcohol intervention has been shown to increase quit attempts for youth with heavier alcohol use histories (Brown et al., 2005). In the present study, we examined rates of self-selection into the three formats of this alcohol intervention: group, individual, and website; and examined differences between intervention participants and the general school population and across the three formats. Over four years, students at four schools were surveyed (n=6000) and were provided the opportunity to participate in Project Options (PO). Youth who were selected into PO (n=1147) were younger and more likely to identify as African American or Multiple/Other ethnicity than the school populations. More teens in PO reported lifetime alcohol use (65% vs. 60%); however, the school population reported more current (past 30 day) drinking. Boys were more likely to utilize the group format and minority youth were more likely to select the individual format. Findings highlight the utility of multiple intervention formats to engage youth in early intervention for alcohol problems.

Adolescent↗

PubMed2005

A prospective study of risk and protective factors for substance use among impoverished women living in temporary shelter settings in Los Angeles County.

Alcohol and drug use are significant public health problems facing homeless women, but few prospective studies have examined risk and protective factors for substance use in this population. This 6-month prospective study identified psychosocial, behavioral, and economic predictors of drinking to intoxication, crack use, and marijuana use in a probability sample of 402 women living in temporary shelter settings in Los Angeles County with a simple majority of homeless residents (92% of these women had a history of homelessness). Engaging in sexual risk behavior and having depressive symptoms were risk factors for more frequent intoxication, marijuana use, and crack use. Drinking to intoxication was additionally predicted by perceived HIV susceptibility, lower social support, more avoidant and less active coping, and lower self-esteem. Additional predictors of marijuana use included partner alcohol misuse and less social support, whereas more frequent crack use was additionally predicted by partner alcohol misuse, lack of economic resources, and more avoidant and less active coping. These findings suggest that effective substance use programs may need an integrative approach that addresses other types of risk behaviors, assists women in strengthening their support networks and learning effective coping skills, and provides access to basic services (e.g., housing, health care). For women in relationships, there may be a further need to address issues of partner substance use.

Adaptation, Psychological↗

PubMed2005

Marijuana use and later problems: when frequency of recent use explains age of initiation effects (and when it does not).

Tobacco, alcohol, and marijuana are among the most commonly used drugs during adolescence. Initiation of marijuana use typically peaks at age 15, with risk of initiation continuing throughout adolescence. The goal of the current study was to prospectively examine the influence of age of marijuana initiation on four outcomes: physical health, mental health, illicit drug use other than marijuana, and marijuana-use related consequences at age 18. We controlled for several important predictors of adolescent drug use and its associated consequences, including demographics, social bonding variables, personality variables, and recent use of marijuana. Baseline survey data were collected in 1984 at grade 7 and follow up surveys were conducted at grades 8, 9, 10, and 12 (N = 2079). This initiates-only sample was 47% female, 66% White, 11% African American, 13% Hispanic, 5% Asian, and 5% other race or ethnicity. Findings indicated that age of initiation predicted marijuana consequences and other illicit drug use after controlling for demographic, social, and behavioral factors. However, once frequency of recent marijuana use was included in the models, age of initiation was only associated with other illicit drug use. Both primary and secondary prevention are needed to curb marijuana use and its associated harms.

Adolescent↗

PubMed2005

Identification of and guidance for problem drinking by general medical providers: results from a national survey.

BACKGROUND: Heavy alcohol use is associated with health costs and medical problems. There has been a growing consensus that primary care patients should be screened for alcohol problems. OBJECTIVES: We examined rates at which patients were asked about alcohol or drug use and problems, extending research in this area by using a standardized problem drinking instrument with a large national sample, examining community level variables, and assessing the extent to which patients who were identified received follow-up. SUBJECTS: A subsample of 7371 persons from the 1998 Healthcare for Communities survey who reported visiting a general medical provider (GMP) in the past year. MEASURES: Participants completed questionnaires on demographics, mental and physical health, alcohol, drug use and problems, enrollment in a managed health care plan, whether their medical provider asked about alcohol or drug use, and whether they received advice, counseling, or referral. RESULTS: Being asked about alcohol and drug use was associated with being male, young, highly educated, more health problems, mental health diagnosis, and being classified as a problem drinker. Only 48% of problem drinkers received any follow-up, with most being told to "stop drinking" by their GMP. CONCLUSIONS: Few people are queried about alcohol or drug use when they visit a GMP. When problem use is identified, most patients do not receive appropriate follow-up and aftercare. The quality of primary care could improve if GMPs were educated about providing brief advice/counseling and were given information concerning resources in their community to make appropriate referrals for patients.

Adolescent↗

PubMed2005

Developmental considerations for substance use interventions from middle school through college.

This article summarizes a symposium organized by Dr. Elizabeth D'Amico and presented at the 2004 Annual Meeting of the Research Society on Alcoholism in Vancouver, Canada. The four presentations illustrate the importance of creating substance use interventions that are developmentally appropriate for youth. They represent innovative approaches to working with preteens, teenagers, and young adults. Dr. D'Amico's paper describes her research on the development of a voluntary brief intervention targeting alcohol use among middle school students. Findings indicated that by using school and community input, she was able to obtain a diverse a sample of youth across grades, sex, ethnicity, and substance use status. Dr. Ellickson's paper describes her research on Project ALERT, a school-based prevention program for middle school youth. Her findings indicate that Project ALERT worked for students at all levels of risk (low, moderate, and high) and for all students combined. Dr. Wagner's Teen Intervention Project was a randomized clinical trial to test the efficacy of a standardized Student Assistance Program for treating middle and high school students with alcohol and other drug problems. The study provided a unique opportunity to begin to examine how development may impact response to an alcohol or other drug intervention. Dr. Turrisi's paper examined processes underlying the nature of the effects of a parent intervention on college student drinking tendencies. Findings suggested that the parent intervention seems to have its impact on student drinking by reducing the influence of negative communications and decreasing the susceptibility of influences from closest friends. Dr. Kim Fromme provided concluding remarks.

Adolescent↗

PubMed2005

Processes linking adolescent problems to substance-use problems in late young adulthood.

OBJECTIVE: The current study explores three avenues in early young adulthood through which adolescent problems may be linked to later substance use problems: problematic substance use, failure to assume adult roles and responsibilities, and exposure to pro-drug social influences. METHOD: Participants (N = 1,986; 49% female) filled out surveys at ages 18, 23 and 29. Participants were 67% white, 9% black, 10% Hispanic and 8% Asian. Deviance, poor mental health, substance use, alcohol and other drug (AOD) problems, and school dropout were measured at age 18. AOD problems were also measured at age 23, as were role changes (e.g., marriage) and pro-drug social influences (e.g., friends use drugs). Indicators of substance abuse and dependence were measured at age 29. Demographics and family history of AOD were covariates. RESULTS: Reporting more deviant behavior and heavier drinking at age 18 was associated with a higher likelihood of abuse and dependence at age 29. Alcohol use and pro-drug social influences at age 23 appeared to mediate the effects of adolescent substance use; lack of role assumption did not. The effect of poor mental health at age 18 was not mediated by any set of variables but instead appeared to directly predict dependence at age 29. CONCLUSIONS: Findings highlight the importance of early young adult drinking and substance-using peers in continuing patterns of heavy substance use developed during adolescence and also underscore the long-term impact of poor mental health during adolescence on substance use problems in late young adulthood.

Adolescent↗

PubMed2004

Impact of consent procedures on reported levels of adolescent alcohol use.

This study examined sample bias related to parental consent procedures in school-based survey research on alcohol-related behavior. Alcohol prevalence and severity of use estimates from a high school student survey using traditional-active parental consent (N = 1,429) were compared with estimates from 2 student surveys using alternative parental consent procedures (passive consent; N = 2,210 and N = 3,231). Traditional-active parental consent procedures resulted in underrepresentation of lifetime drinkers. Furthermore, traditional-active parental consent procedures resulted in lower levels of high-risk drinking, and this bias was most evident for Caucasians and both boys and girls. Findings accentuate the need for administrators, policymakers, and researchers to consider the impact consent procedure related bias may have on results and interpretation of findings from school-based substance use research.

Adolescent↗

PubMed2003

Strategies for reduction and cessation of alcohol use: adolescent preferences.

BACKGROUND: Although the majority of youth and adults resolve alcohol problems without formal treatment, we know little about the strategies used by youth in their efforts to decrease alcohol use. Recent studies have begun to address change efforts that adolescents report being helpful in cutting down or stopping alcohol use. The current study seeks to improve our understanding of adolescent change processes in alcohol use by examining the perceptions of high school students. METHODS: As part of a secondary alcohol intervention study of high school students (ages 12-18; 51% male), 1069 participants completed an anonymous supplemental questionnaire on change strategies for cutting down and stopping alcohol use. Based on content analysis of youth-generated responses, a classification system consisting of nine broad categories was developed (e.g., informal-interpersonal supports, formal aids, alternative activities). Participant responses were independently coded by two raters trained to criterion. Cases with full agreement (n = 934; 96%) were used for data analyses of methods for cutting down drinking, stopping drinking, and strategies recommended for a friend. RESULTS: The five most frequently youth-generated change strategies to alter drinking were environmental exposure management (e.g., avoid drinking situations, 19%); informal interpersonal supports (e.g., talk to a friend, 18%); formal aids (e.g., peer support group, counselor, 17%); behavioral self-management (e.g., limit consumption, 14%); and alternative activities (e.g., recreation, sports, 10%). Whereas informal interpersonal supports were consistently endorsed for all change situations, behavioral self-management strategies were viewed as more useful for reduction of drinking and formal aids more critical for cessation efforts. Some differences were observed in youth-generated strategies for changing their own drinking compared with efforts to help friends, with environmental changes (e.g., reducing exposure to risk situations and people, formal aids) more often considered when changing youth's own behavior, and strategies reflecting a need for personal change (e.g., education) recommended to others. CONCLUSIONS: Our findings support theoretical conceptualizations of alcohol and drug problem resolution that accommodates multiple pathways to recovery. The normative information about specific change strategies generated by youth may further aid in the design of interventions more acceptable for adolescents.

Adolescent↗

PubMed2003

Outcomes of alcohol treatment for adolescents.

Alcohol and other drug use by youth continue to be an important focus for this nation. Both moderate and heavy alcohol consumption are associated with a higher risk of alcohol-related medical consequences and accidental injuries for youth. Despite knowledge of possible consequences, a high percentage (30%) of high school students nationwide reports episodes of hazardous drinking (five or more drinks on one occasion). Increased awareness and concern related to adolescent substance use has led to the outgrowth of additional treatment facilities and programs for this age group. This chapter examines the impact of developmental factors on the assessment process and subsequent treatment of adolescent alcohol use disorders. In addition, treatment outcome research, intervention studies, relapse, and factors that may influence the recovery process of youth are discussed.

Adolescent↗

PubMed2002

Brief prevention for adolescent risk-taking behavior.

AIMS: Despite widespread prevention efforts to decrease adolescent risk-taking, substance use and driving after drinking (DD) are prevalent in the United States. The current study compared the efficacy of an abbreviated version of Drug Abuse and Resistance Education (DARE-A) to a new Risk Skills Training Program (RSTP). DESIGN: Adolescent participation in drinking, drug use, DD and riding with a drunk driver was examined longitudinally. After baseline assessments, adolescents were randomly assigned to the RSTP. DARE-A or a no intervention control group and then completed 2-month post-test and 6-month follow-up assessments. SETTING: Adolescents attended a mid-sized suburban high school. PARTICIPANTS: The sample (N = 300) was comprised of 58% females and the age range was 14-19 years. INTERVENTION: The RSTP was developed to target several risk behaviors and to examine the feasibility of conducting a brief personalized prevention program in a group setting. DARE-A focused on increasing knowledge and understanding the deleterious effects of substance use. MEASUREMENTS: Risk-taking behavior, perception of peer risk-taking and positive and negative alcohol expectancies were assessed. FINDINGS: RSTP participants decreased participation in several risk behaviors at post-test, but reductions were not maintained at 6-month follow-up. The control and DARE-A groups increased their positive and decreased their negative alcohol expectancies. The control group increased their alcohol consumption. CONCLUSIONS: Results suggest that a brief, personalized, group prevention program is a feasible approach to reducing adolescent risk-taking. Strategies must be developed to solidify these positive changes so that they are longer-lasting.

Adolescent↗

PubMed2002

Treating adolescents together or individually? Issues in adolescent substance abuse interventions.

This article summarizes the proceedings of a symposium, chaired by Peter Monti and cochaired by Tracy O'Leary, that was presented at the 2001 RSA Meeting in Montreal, Quebec. The aim of this symposium was to present data on group- and individual-based interventions for adolescent alcohol and substance abuse, with a discussion of the implications of research findings bearing on developmental considerations when working with adolescents and young adults. Elizabeth J. D'Amico, PhD, reviewed recent findings on adolescents' choice of type of substance abuse treatment. Jennifer L. Maggs, PhD, presented a developmental perspective on this issue. Tracy O'Leary, PhD, presented data on enhancing motivational interviewing with the presence of a supportive peer for college students cited for alcohol infractions. Mary E. Larimer, PhD, presented 1-year follow-up results of the Greeks 2000 Project, a 5-year longitudinal study designed to evaluate the efficacy of an alcohol abuse prevention program provided to college students who were entering a pledge class (first year) of Greek houses. Barbara McCrady, PhD, a noted expert on the treatment of couples for substance abuse problems, served as discussant.

Adolescent↗

PubMed2002

Does alcohol use mediate the association between alcohol evaluations and alcohol-related problems in adolescents?

Alcohol use becomes more frequent during adolescence, with the percentage of youth who drink doubling from 8th grade to 12th grade. The escalation in drinking behavior during adolescence is often associated with increased problems and other risk behavior, such as drunk driving. In this study, adolescents (N = 557) were recruited from an emergency department to assess their alcohol use, positive and negative evaluations about alcohol, driving after drinking, and problems experienced from drinking. Analyses explored the mediational role of drinking behavior between adolescents' evaluations and problems from drinking and between evaluations and driving after drinking. The findings indicated that drinking behavior partially mediated the association between positive evaluations and problems experienced from drinking but did not mediate the association between evaluations and drunk driving.

Adolescent↗